The purpose of this project is to evaluate the ability of noninvasive ultrasound imaging to contribute to the diagnosis of impaired swallowing and speech and to evaluate the structure of the oropharynx (tongue, palate, oral muscles, hyoid) and larynx in normal and abnormal populations. We have evaluated 30 patients with Beckwith-Weideman Syndrome (BWS) who often present with macroglossia (enlarged tongues). Measurements of tongue symmetry and area revealed that patients with BWS appear to have lingual asymmetry that is different from siblings without BWS. These differences appear to become less noticeable with increased age and are mild in adulthood. No significant relationship between size or symmetry of the tongue and speech intelligibility was uncovered in the adolescents and adults studied. Relationships between type of glossectomy procedure and lingual symmetry, speech and swallowing function are in progress. Exploration of ultrasound imaging to evaluate the effects of treatment on tumor growth and to evaluate the reliability of ultrasound imaging in the detection of tumors of the tongue hypopharynx and larynx are in progress. We are collaborating with otolaryngology, oncology and radiology departments of the Greater Baltimore Medical Center in the design and implementation of this project. Ongoing efforts to establish a uniform data acquisition system for collecting ultrasound images are underway with staff of GBMC, with staff training planned. A rating system is being developed by the physicians to assist us in examining images and developing algorithms to distinguish normal from abnormal tissues from the digitized data. We plan to expand our analysis techniques and to develop a system that will use neural networks for tumor detection. The clinical impact of this project on diagnosis of head and neck tumors remains promising.